Summary :
Responsible for verifying provider licensing and credentials, managing payer enrollment, and ensuring compliance with healthcare standards. Supports timely credentialing and re-credentialing for providers.
Responsibilities :
- Collect and verify provider documents (licenses, education, certifications, malpractice, etc.).
- Process credentialing and re-credentialing applications with payers (Medicare, Medicaid, commercial plans).
- Maintain provider files, databases, and systems (e.g., CAQH, NPPES, PECOS).
- Track expirations and ensure timely renewals.
- Communicate application status and requirements to providers and internal teams.
- Ensure compliance with HIPAA, NCQA, Joint Commission, and other regulations.
Qualifications :
Experience in healthcare credentialing or provider enrollment preferred.2+ years in Behavioral Health credentialingExperience working in Modio credentialing databaseKnowledge of CAQH, PECOS, and payer requirements is an advantage.Strong attention to detail, organization, and communication skills.Proficient with Microsoft Office and credentialing systems.Willing to work US hours from Monday to FridayBenefits
Why join us as?
You’ll see dozens of marketing analysis set-ups, you’ll learn how marketing strategies are built, what matters, and why. You’ll have the opportunity of solving real customer problems on an everyday basis.